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 18 November 2017

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News

Surgical management and long-term outcome of liver hydatid cysts

Findings in the most recent issue of Surgery show that a surgical strategy aimed at complete removal of cystic and pericystic tissue leads to 23% postoperative morbidity, no mortality, and no recurrence of disease with a median follow-up of less than 8 years.

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Dr Bühler and colleagues from Switzerland conducted a retrospective study was to evaluate clinical presentation and long-term outcome of patients treated surgically for complicated liver hydatid cysts.

84 patients with liver hydatid cysts underwent an operation at the Geneva University Hospital between 1980 and 1999.

The researchers evaluated clinical presentation, postoperative morbidity, mortality, and long-term recurrence rate.

The research team noted that among the 84 patients with liver hydatid disease, 35 patients (41%) presented complicated cysts (cysts that had developed a fistula into adjacent structures or organs).

In most patients, the fistula communicated with the biliary tree (n=25), but the investigators also observed communication with the right lung (n=3), the right diaphragm (n=2), liver parenchyma (n=1), and peritoneal cavity (n=1).

The investigative team were able to completely remove the cystic disease in 24 of 35 patients (70%).

There was complete removal of the cystic disease in 24 of 35 patients (70%)
Surgery

In 11 patients, fragments of cysts were not removed by the researchers because of their location adjacent to main vessels.

The investigators showed that postoperatively, 8 patients (23%) developed a severe complication (grade II and III).

The research team also noted that there were no postoperative deaths, and no recurrences of hydatid disease were observed with a median follow-up of 9 years (complete follow-up was obtained in 69% of patients).

Dr Bühler concludes, “Complicated liver hydatid disease is frequent and was observed in almost half of patients operated for liver hydatid cysts at our center.”

“Using a surgical strategy aimed at complete removal of cystic and pericystic tissue with simultaneous treatment of the fistulous tract, we observed 23% postoperative morbidity, no mortality, and no recurrence of disease with a median follow-up of less than 8 years.”

Surgery 2005: 137(3): 312
09 March 2005

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